19 CSR 30-40.342
Application and Licensure Requirements for the Initial Licensure and Relicensure of Emergency
Medical Technician-Basics, Emergency Medical TechnicianIntermediate,
and
Emergency
Medical
TechnicianParamedics
PURPOSE: This rule provides the requirements related to the initial
licensure and relicensure of EMT-Basics and EMT-Paramedics.
PUBLISHER’S NOTE: The secretary of state has determined that the
publication of the entire text of the material which is incorporated
by reference as a portion of this rule would be unduly cumbersome
and expensive. This material as incorporated by reference in this
rule shall be maintained by the agency at its headquarters and
shall be made available to the public for inspection and copying
at no more than the actual cost of reproduction. This note applies
only to the reference material. The entire text of the rule is printed
here.
(1) Application Requirements for Emergency Medical Technician
(EMT) Licensure.
(A) Each applicant for licensure or relicensure as an EMTBasic, EMT-Intermediate, or EMT-Paramedic shall submit an
application for licensure to the Emergency Medical Services
(EMS) Bureau. An applicant for relicensure must submit their
application no less than thirty (30) days or no more than one
hundred twenty (120) days prior to the expiration date of their
current license.
(B) An application shall include, but is not limited to,
the following information: whether an initial licensure or
relicensure application; if previously licensed, their license
number and expiration date; type of licensure applied for (EMTBasic (EMT-B), EMT-Intermediate (EMT-I), or EMT-Paramedic
(EMT-P)); type of certification or education used for licensure or
relicensure; applicant’s name, signature, address, date of birth,
sex, daytime telephone number, email address (if applicable),
and Social Security number; if applicable, whether or not the
applicant is a past member of the United States Armed Forces
including National Guard and Reserves who has been honorably
discharged within the past two (2) years who requests an EMT-B
United States Armed Forces license and, if applicable, attach to
the application a copy of the applicant’s certificate of release or
discharge from active duty (DD form 214) or an NGB-22 which
verifies the applicant’s honorable discharge and discharge
date; whether or not the applicant is a current member of
the United States Armed Forces including National Guard
and Reserves who requests an EMT-B United States Armed
Forces license and, if applicable, attach to the application a
copy of the applicant’s common access card; type of present
primary EMS affiliation. prior administrative licensure actions
taken against any license or certification in Missouri or any
other state; whether they have been finally adjudicated and
found guilty, or entered a plea of guilty or nolo contendere,
in a criminal prosecution under the laws of any state or of
the United States, whether or not they received a suspended
imposition of sentence for any criminal offense; if the answer
is yes to the preceding statement, they must attach to their
application a certified copy of all charging documents (such
as complaints, informations, or indictments), judgments and
sentencing information, plea agreements and probation terms,
and any other information they wish considered; certification
by the applicant that they have the ability to speak, read, and
write the English language; certification by the applicant
that they do not have a physical or mental impairment which
would substantially limit their ability to perform the essential
functions of an emergency medical technician position with
or without a reasonable accommodation; certification by the
applicant that if relicensing using continuing education that
they have successfully completed the required continuing
education in accordance with state regulations, have attached
a list of these continuing education units, and are in possession
of documents of the required continuing education, and
will make all records available to the EMS Bureau upon
request under penalty of license action up to and including
revocation; certification by the applicant that the application
contains no misrepresentation or falsifications and that the
information given by them is true and complete to the best of
their knowledge; certification by the applicant that they have
the intention and the ability to comply with the regulations
promulgated under the Comprehensive Emergency Medical
Services Systems Act, Chapter 190, RSMo; certification by the
applicant that they have been a resident of Missouri for five
(5) consecutive years prior to the date on their application or
have attached to the application at least two (2) completed
fingerprint cards.
(C) All applicants shall provide their Social Security number
on their application so the Bureau of EMS can perform criminal
history checks to determine the recency and relatedness of any
criminal convictions prior to the licensure or relicensure of the
applicant. Criminal history checks that the EMS Bureau finds
not to be relevant to the licensure or relicensure of an EMT will
not be maintained in the applicant’s file.
(D) All applicants shall attach to the application a list of
the qualifying continuing education used for relicensure, as
applicable. This list shall include verification by the applicant’s
training officer or medical director that all core requirements
have been met. Receipt of this list does not constitute approval
of continuing education by the EMS Bureau.
(E) An applicant shall provide all information and certification
required on the EMS Bureau application for EMT licensure.
Incomplete or inaccurate information on an application shall
be cause to deny or take action upon a license.
(F) An applicant shall disclose if they have ever been
subject to limitation, suspension, or termination of their right
to practice in a health care occupation and/or voluntarily
surrendered a health care license or certification in any state.
(2) EMT-Basic (EMT-B) Licensure and Relicensure Requirements.
(A) EMT-Basic (Initial Licensure). Initial licensure requirements
apply to any person who was not licensed in Missouri prior to
August 28, 1998, as an attendant or attendant-driver by the EMS
Bureau or whose Missouri license has expired for more than
two (2) years. The applicant for initial licensure shall submit
with their license application to the EMS Bureau evidence of
current certification with the National Registry of EMTs as an
EMT-B, EMT-I, or EMT-P. Any applicant for initial licensure as
an EMT-B who is a past member of the United States Armed
Forces including National Guard and Reserves who has been
honorably discharged from the United States Armed Forces
including National Guard and Reserves within the past two
(2) years may request an EMT-B United States Armed Forces
license with the EMS Bureau. The applicant shall submit to the
EMS Bureau a copy of the applicant’s certificate of release or
discharge from active duty (a DD form 214) or NGB-22 which
verifies the applicant’s honorable discharge and discharge
date in order to receive an EMT-B United States Armed Forces
license from the EMS Bureau that will provide the licensee’s
date of honorable military discharge. Any applicant for initial
licensure as an EMT-B who is a current member of the United
States Armed Forces including National Guard and Reserves
may request an EMT-B United States Armed Forces license with
the EMS Bureau. The applicant shall submit to the EMS Bureau
a copy of the applicant’s common access card in order to
receive an EMT-B United States Armed Forces license from the
EMS Bureau that will provide that the applicant is currently in
the United States Armed Forces including National Guard and
Reserves.
(B) The EMT-B in Missouri may be permitted to perform
blood glucose analysis, twelve (12) lead EKG acquisition and
transmission, non-invasive airway devices not intended
to be placed in the trachea, and all skills in the National
Scope of Practice for Emergency Medical Technicians which is
incorporated by reference in this rule as published in 2007 by
the U.S. Department of Transportation and is available at U.S.
Department of Transportation, Office of Emergency Medical
Services, West Building W 44-314, 1200 New Jersey Ave. SE, NTI
140, Washington, DC 20590. This rule does not incorporate any
subsequent amendments or additions.
(C) EMT-Basic (Relicensure or Step Down from EMT-P or EMTI).
1. The applicant for relicensure shall submit with their
license application to the EMS Bureau evidence of current
certification with the National Registry of EMTs as an EMTBasic, EMT-Intermediate, or EMT-Paramedic; or
2. An applicant shall certify to the EMS Bureau:
A. That they have successfully completed one hundred
(100) hours of continuing education which meet the EMS
Bureau’s approval criteria under 19 CSR 30-40.331, forty-eight
(48) hours of which cover all elements of the EMT-B core
continuing education curriculum and fifty-two (52) hours of
which may be elective topics from the EMT-B, EMT-I, or EMT-P
curriculum;
B. That they are able to produce documentation of the
required continuing education, and will make all records
available to the EMS Bureau upon request. Licensees shall
maintain such records for a period of five (5) years after the
date of relicensure. Failure to obtain and retain complete and
accurate documentation shall be cause for taking action upon
a license; and
C. That they have current basic cardiac life support
training (does not count towards core continuing education
curriculum).
(3) Any applicant for relicensure as an EMT-B who has been
honorably discharged from the United States Armed Forces
including National Guard and Reserves within the past two
(2) years may request an EMT-B United States Armed Forces
license with the EMS Bureau. The applicant shall submit to the
EMS Bureau a copy of the applicant’s certificate of release or
discharge from active duty (a DD form 214) or an NGB-22 which
verifies the applicant’s honorable discharge and discharge date
in order to receive an EMT-B United States Armed Forces license
from the EMS Bureau that will provide the licensee’s date of
honorable military discharge. Any applicant for relicensure as
an EMT-B who is a current member of the United States Armed
Forces including National Guard and Reserves may request an
EMT-B United States Armed Forces license with the EMS Bureau.
The applicant shall submit to the EMS Bureau a copy of the
applicant’s common access card in order to receive an EMT-B
United States Armed Forces license from the EMS Bureau that
will provide that the applicant is currently in the United States
Armed Forces including National Guard and Reserves.
(4) EMT-Paramedic Licensure and Relicensure Requirements.
(A) EMT-Paramedic (Initial Licensure). Initial licensure
requirements apply to any person who was not licensed in
Missouri prior to August 28, 1998, as a mobile emergency
medical technician by the EMS Bureau or whose Missouri
license has expired for more than two (2) years. The applicant
for initial licensure shall submit with their license application
to the EMS Bureau evidence of current certification with the
National Registry of EMTs as an EMT-P.
(B) EMT-Paramedic (Relicensure).
1. The applicant for relicensure shall submit with their
SENIOR SERVICES
license application to the EMS Bureau evidence of current
certification with the National Registry of EMTs as an EMT-P; or
2. An applicant shall certify to the EMS Bureau—
A. That they have successfully completed one hundred
forty-four (144) hours of continuing education which meet
the EMS Bureau’s approval criteria under 19 CSR 30-40.331,
forty-eight (48) hours of which may be elective topics and the
remaining ninety-six (96) hours covering all elements of the
EMT-P core continuing education curriculum;
B. That they are able to produce documentation of
the required continuing education and will make all records
available to the EMS Bureau upon request. Licensees shall
maintain such records for a period of five (5) years after the
date of relicensure. Failure to obtain and retain complete and
accurate documentation shall be cause for taking action upon
a license; and
C. That they have current advanced cardiac life support
training (can be counted towards the refresher requirement).
(5) EMT-Intermediate (EMT-I) Licensure and Relicensure
Requirements.
(A) EMT-I (Initial Licensure). Initial licensure requirements
apply to any person applying for licensure in Missouri.
The applicant for initial licensure shall submit with their
license application to the EMS Bureau evidence of current
certification with the National Registry of Emergency Medical
Technicians as an EMT-I. The EMT-I in Missouri may perform
all the skills except intraosseous infusions in the National
EMS Scope of Practice Model for Advanced EMT which is
incorporated by reference in this rule as published in 2007 by
the U.S. Department of Transportation and is available at U.S.
Department of Transportation, Office of Emergency Medical
Services, West Building W 44-314, 1200 New Jersey Ave. SE, NTI
140, Washington DC 20590. This rule does not incorporate any
subsequent amendments or additions.
(B) EMT-Intermediate (EMT-I) Relicensure.
1. The applicant for relicensure shall submit with their
license application to the EMS Bureau evidence of current
certification with the National Registry of EMTs as an EMT-I; or
2. An applicant shall certify to the EMS Bureau—
A. That they have successfully completed one hundred
forty-four (144) hours of continuing education which meet the
EMS Bureau’s approval criteria under 19 CSR 30-40.331, seventytwo (72) hours of which cover all elements of the EMT-I core
continuing education curriculum and seventy-two (72) hours
of which may be elective topics from the EMT-B, EMT-I, or
EMT-P curriculum;
B. That they are able to produce documentation of the
required continuing education and shall make all records
available to the EMS Bureau upon request. Licensees shall
maintain such records for a period of five (5) years after the
date of relicensure; and
C. Applicants shall produce a copy of the front and back
of a basic cardiac life support training card which confirms
that the applicant has successfully completed a basic life
support training course within the past two (2) years.
(C) EMT-B Step Down from EMT-P or EMT-I.
1. The applicant for relicensure shall submit with their
license application to the EMS Bureau evidence of current
certification with the National Registry of EMTs as an EMT-B,
EMT-I, or EMT-P; or
2. An applicant shall certify to the EMS Bureau—
A. That they have successfully completed one hundred
(100) hours of continuing education which meet the EMS
Bureau’s approval criteria under 19 CSR 30-40.331, forty-eight
(48) hours of which cover all elements of the EMT-B core
continuing education curriculum and fifty-two (52) hours of
which may be elective topics from the EMT-B, EMT-I, or EMT-P
curriculum;
B. That they are able to produce documentation of the
required continuing education and shall make all records
available to the EMS Bureau upon request. Licensees shall
maintain such records for a period of five (5) years after the
date of relicensure; and
C. Applicants shall also have current basic cardiac life
support training. This does not count towards core continuing
education curriculum.
SENIOR SERVICES
AUTHORITY: sections 190.142, 190.160, 190.165, and 190.185, RSMo
Supp. 2013.* Emergency rule filed Aug. 28, 1998, effective Sept.
7, 1998, expired March 5, 1999. Original rule filed Sept. 1, 1998,
effective Feb. 28, 1999. Amended: Filed Aug. 27, 2009, effective
April 30, 2010. Amended: Filed March 11, 2016, effective Oct. 30,
2016. **
*Original authority: 190.142, RSMo 1998, amended 1999, 2002; 190.160, RSMo 1973,
amended 1998, 2002; 190.165, RSMo 1973, amended 1978, 1998, 2002; and 190.185,
RSMo 1973, amended 1989, 1993, 1995, 1998, 2002.
**Pursuant to Executive Order 21-09, 19 CSR 30-40.342, subsection (2)(B) was suspended from
October 9, 2020 through December 31, 2021. Pursuant to Executive Order 21-09, 19 CSR 30-40.342,
subsection (2)(B) was suspended from March 3, 2021 through December 31, 2021.